EUS 在探索轻度急性胆源性胰腺炎的病因方面，对于常规放射影像学方法未能发现胆道来源的病例具有重要价值。
EUS in exploring the etiology of mild acute biliary pancreatitis with a negative finding of biliary origin by conventional radiological methods.
机构信息
Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China.
出版信息
J Gastroenterol Hepatol. 2011 Oct;26(10):1500-3. doi: 10.1111/j.1440-1746.2011.06755.x.
BACKGROUND AND AIM
Conventional radiological methods, including transcutaneous ultrasonography (US), computed tomography (CT), and magnetic resonance cholangiopancreatography (MRCP) are non-invasive and recommended for the detection of etiologies of acute biliary pancreatitis (ABP). There are still, however, a number of patients whose etiologies cannot be found by these methods. The value of endoscopic ultrasound (EUS) for this population is still unknown. The aim of the present study was to evaluate the role of EUS in exploring the unknown etiology of mild ABP.
METHODS
The data from patients with mild ABP admitted to Changhai Hospital, Shanghai, China, from June 2006 to December 2009 were retrospectively collected, and the results of the imaging methods in detecting biliary disorders were analyzed.
RESULTS
A total of 223 patients with mild ABP underwent both US and CT. Of these, 106 underwent additional MRCP. There were still 37 patients with unknown biliary etiologies, even after the use of the conventional methods mentioned earlier. EUS was conducted in 33 of these patients. Abnormalities associated with the etiology of mild ABP were found in 14 cases (42.4%) confirmed by subsequent endoscopic retrograde cholangiopancreatography, with biliary stones in 11 cases, biliary sludge in two cases, and ampullary adenocarcinoma in one case.
CONCLUSION
The results suggest that EUS is helpful in the identification of the etiology of mild biliary pancreatitis when conventional radiological imaging is negative or equivocal.
背景与目的
经皮超声（US）、计算机断层扫描（CT）和磁共振胆胰管成像（MRCP）等常规影像学方法是非侵入性的，推荐用于检测急性胆源性胰腺炎（ABP）的病因。然而，仍有一些患者无法通过这些方法找到病因。超声内镜（EUS）在该人群中的价值仍不清楚。本研究旨在评估 EUS 在探索轻度 ABP 未知病因中的作用。
方法
回顾性收集 2006 年 6 月至 2009 年 12 月期间上海长海医院收治的轻度 ABP 患者的资料，分析了影像学方法在检测胆道疾病中的结果。
结果
共有 223 例轻度 ABP 患者接受了 US 和 CT 检查。其中 106 例患者进行了额外的 MRCP。尽管使用了上述常规方法，仍有 37 例患者的胆道病因仍不清楚。对其中 33 例患者进行了 EUS 检查。在这 33 例患者中，有 14 例（42.4%）通过后续的内镜逆行胰胆管造影术（ERCP）发现与轻度 ABP 病因相关的异常，其中胆管结石 11 例，胆管淤泥 2 例，壶腹腺癌 1 例。
结论
结果表明，当常规影像学检查为阴性或不确定时，EUS 有助于确定轻度胆源性胰腺炎的病因。
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